Membership Cancellation Request Form

Membership Cancellation Request
Date

MonthDayYear
Date
Name

First NameLast Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
What is the main reason for cancelling your membership?

Other
How often do you use your sessions?

Other
On a scale of 1-5 (5 being the highest), how do you rank your overall experience at Sccoaches?
What were your desired health goals when you joined the club?
Did you meet those goals?
How would meeting those goals have impacted your life as it is today?
Did staff provide a good customer experience?
Did you find your staff knowledgeable?
Did you find your gym clean?

We want your input!

Rows	Definitely	Probably	Not Sure	Probably Not	Definitely Not
Will you use our service in the future?
Will you recommend our service to others?

How can we improve our service?
I hearby certify that I wish to cancel my membership with Sccoaches. I understand that my account must be in good standing in order to complete this requst. I understand that I am responsible for any billing that will occur within the next 30 days. I understand I will be provided a copy of the Member Cancellation request via email.
Should be Empty: